Cilosta
Generic Name
Cilostazol 100 mg Tablet
Manufacturer
General Pharmaceutical Company Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cilosta 100 mg tablet | ৳ 12.09 | ৳ 120.90 |
Description
Overview of the medicine
Cilostazol is a quinolinone derivative used to reduce symptoms of intermittent claudication, such as leg pain or cramping, that occurs during walking. It works by improving blood flow and reducing platelet aggregation.
Uses & Indications
Dosage
Adults
Recommended dose is 100 mg orally twice daily, at least 30 minutes before or 2 hours after breakfast and dinner. Dosage may be reduced to 50 mg twice daily if necessary.
Elderly
No specific dosage adjustment required for elderly patients.
Renal_impairment
Use with caution in severe renal impairment (creatinine clearance ≤ 25 mL/min); dosage reduction or avoidance may be necessary. Not recommended for end-stage renal disease patients.
How to Take
Take orally twice daily, at least 30 minutes before or 2 hours after meals. Do not crush or chew the tablet.
Mechanism of Action
Cilostazol inhibits phosphodiesterase III (PDE3), leading to an increase in intracellular cyclic AMP (cAMP) levels in platelets and vascular smooth muscle. This results in antiplatelet aggregation effects and vasodilation.
Pharmacokinetics
Onset
Therapeutic effects may take 2-4 weeks to become apparent, with maximum benefit observed after 12 weeks.
Excretion
Primarily excreted in urine (74%) and feces (20%) as metabolites.
Half life
Approximately 11-13 hours (cilostazol) and 25-30 hours (active metabolites).
Absorption
Rapidly absorbed. Bioavailability is increased by a high-fat meal (approximately 30-80%).
Metabolism
Extensively metabolized in the liver, primarily by CYP3A4 and to a lesser extent by CYP2C19 and CYP1A2, into several active metabolites.
Side Effects
Contraindications
- Heart failure of any severity
- Known hypersensitivity to cilostazol or any component of the formulation
- Hemostatic disorders or active bleeding
- Severe renal impairment (CrCl ≤ 25 mL/min)
- Moderate to severe hepatic impairment
- Concomitant use of two or more antiplatelet or anticoagulant agents
Drug Interactions
CYP2C19 inhibitors (e.g., Omeprazole)
Increased plasma concentrations of cilostazol; consider dosage reduction.
Clopidogrel, Aspirin, Warfarin, Heparin
Increased risk of bleeding due to additive antiplatelet/anticoagulant effects.
CYP3A4 inhibitors (e.g., Ketoconazole, Erythromycin, Diltiazem, Grapefruit juice)
Increased plasma concentrations of cilostazol; reduce cilostazol dose to 50 mg twice daily.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include severe headache, diarrhea, tachycardia, and potentially cardiac arrhythmias. Management involves supportive care, gastric lavage if appropriate, and close monitoring.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. It is unknown if cilostazol is excreted in human milk; caution is advised in nursing mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months
Availability
Pharmacies, Hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generics available
Clinical Trials
Numerous clinical trials, including the STOP-PAD and CASPAR trials, have demonstrated the efficacy of cilostazol in improving walking distance and reducing symptoms in patients with intermittent claudication.
Lab Monitoring
- Complete blood count (CBC) periodically, especially during the first few months of therapy, to monitor for potential hematologic abnormalities.
- Renal and hepatic function in patients with pre-existing impairment.
Doctor Notes
- Contraindicated in heart failure of any severity due to increased mortality risk.
- Consider dosage reduction to 50 mg BID when co-administered with strong CYP3A4 or CYP2C19 inhibitors.
- Regular monitoring for bleeding and hematologic abnormalities is recommended, especially in high-risk patients.
Patient Guidelines
- Take the medicine as directed by your doctor, preferably 30 minutes before or 2 hours after meals.
- Do not stop taking the medication without consulting your doctor, even if you feel better.
- Report any unusual bleeding, bruising, or severe side effects to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.
Driving Precautions
Cilostazol may cause dizziness. Patients should be cautioned about operating machinery or driving until they know how they react to the medication.
Lifestyle Advice
- Maintain a healthy diet and regular exercise as advised by your doctor to improve peripheral circulation.
- Stop smoking, as it significantly worsens peripheral arterial disease.
- Manage underlying conditions like diabetes and hypertension.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.